Comparison of Four Invasive Methods for Diagnosis of Helicobacter pylori Infection: Fluorescence in situ Hybridization, Histology, Culture, Rapid Urease Test

Abstract

Background: Helicobacter pylori (H. pylori) is one of the most prevalent pathogenic bacteria globally. Choosing reliable methods will lead to a correct diagnosis of infection. The aim of this study was to evaluate four H. pylori infection diagnostic methods from dispeptic patients. Methods: In this descriptive cross-sectional study, 165 antrum biopsy specimens were obtained from dyspeptic patients referred to the endoscopy unit of Shariati Hospital, Isfahan, Iran, and collected in 2018. Four diagnostic methods of H. pylori, namely histology, culture, rapid urease test (RUT) and fluorescence in situ hybridisation (FISH) were tested for each patient. The gold standard of the study was for positive confirming one of the two tests, RUT or histology. Results: According to the predefined criteria, the prevalence of H. pylori infection was 55.2%. Among the four diagnostic methods, the most sensitive ones were FISH and RUT, respectively (95.7 and 92.3%). Despite the high specificity of the histological examination (100%), its NPV was lower than the other methods (88%). The kappa coefficient of agreement between the gold standard and the tested techniques was perfect (P < 0.001). Conclusion: FISH and histology are recommended in combination with diagnosis of H. pylori infection, which can manage its complications in the most optimal manner.